Industrial Alliance Forms

  • F1A Life Insurance Application
  • F2A Alternative Application
  • F3A Addition of Coverage
  • F4A Request for Change – Individual Life Insurance
  • F5A Beneficiary,Trustee – Assignment for Collateral, Name Change
  • F6A Surrender, Loan, Dividends, Partial Withdrawal
  • F7A Disability Income Insurance Application
  • F8A Perspective Application
  • F10-316A Bank Change Without Specimen
  • F10A Universal Life – Transaction Request
  • F13-166A Medical Requirements
  • F30A Designation of Ownership – Contigent Owner(s)
  • F30-140 Authorization Form
  • F30-161A Questionnaire on Tobacco Use
  • F32A – Transition – Simplified Issue – Form
  • F32A-1 -Transition – Simplified Issue – Definitions of CI and Medical Conditions Covered
  • F35-55A Disability – Claimant’s Statement
  • F35-136A Changes to an Existing PAC
  • F35-275A – Direct deposit request
  • F37-16A Health Modules – Claimant’s Statement
  • F37-18A Claimant’s Statement – Accidental Fracture
  • F37-20A Critical Illness
  • F39-18A Endorsement – Index Account US Stocks DAQ (Series II)
  • F51-201A – Limited Trading Authorization
  • F51-208A Proceeds of crime (money laundering) and terrorist financing act
  • FAQ – Limited Trading Authorization
  • F55-21A Death claim – Claimant’s Statement
  • F55-21(2) – Death Claim – Claimant’s Statement – Simplified Version
  • F55-22A Proof of Death – Attending Physician Statement
  • Q1A Questionnaires
  • Q2A Financial Questionnaire
  • Q3A Preferred Underwriting Prequalification Questionnaire
  • Q4A Critical Illness Questionnaire
  • Q5A Medical Questionnaires
  • Q6A Disabilty Insurance Questionnaire Complementary to the Application

 

To top